典型文献
The combination of creatine kinase-myocardial band isoenzyme and point-of-care cardiac troponin/contemporary cardiac troponin for the early diagnosis of acute myocardial infarction
文献摘要：
BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-cTn)assay.Herein,we aim to assess the value of creatine kinase-myocardial band isoenzyme(CK-MB)combined with different cardiac troponin(cTn)assays in AMI diagnosis.METHODS:This multicenter,observational study included 3,706 patients with acute chest pain from September 1,2015,to September 30,2017.We classified the participants into three groups according to the cTn assays:the point-of-care cTn(POC-cTn)group,the contemporary cTn(c-cTn)group,and hs-cTn group.The diagnostic value was quantified using sensitivity and the area under the curve(AUC).RESULTS:Compared to the single POC-cTn/c-cTn assays,combining CK-MB and POC-cTn/c-cTn increased the diagnostic sensitivity of AMI(56.1％vs.63.9％,P＜0.001;82.7％vs.84.3％,P=0.025).In contrast,combining CK-MB and hs-cTn did not change the sensitivity compared with hs-cTn alone(95.0％vs.95.0％,P＞0.999).In the subgroup analysis,the sensitivity of combining CK-MB and c-cTn increased with time from symptom onset＜6 h compared with c-cTn alone(72.8％vs.75.0％,P=0.046),while the sensitivity did not increase with time from symptom onset＞6 h(97.5％vs.98.3％,P=0.317).The AUC of the combination of CK-MB and POC-cTn significantly increased compared to the single POC-cTn assay(0.776 vs.0.750,P=0.002).The AUC of the combined CK-MB and c-cTn/hs-cTn assays did not significantly decrease compared with that of the single c-cTn/hs-cTn assays within 6 h.CONCLUSIONS:The combination of CK-MB and POC-cTn or c-cTn may be valuable for the early diagnosis of AMI,especially when hs-cTn is not available.
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作者姓名：
Guang-mei Wang;Yong Li;Shuo Wu;Wen Zheng;Jing-jing Ma;Feng Xu;Jia-qi Zheng;He Zhang;Jia-li Wang;Yu-guo Chen
作者机构：
Department of Emergency Medicine,Qilu Hospital of Shandong University,Jinan 250012,China;Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine;Institute of Emergency and Critical Care Medicine of Shandong University;Chest Pain Center;Qilu Hospital of Shandong University,Jinan 250012,China;Key Laboratory of Emergency and Critical Care Medicine of Shandong Province;Key Laboratory of Cardiopulmonary-cerebral Resuscitation Research of Shandong Province;Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine;Key Laboratory of Cardiovascular Remodeling and Function Research,Chinese Ministry of Education,Chinese Ministry of Health and Chinese Academy of Medical Sciences;The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine
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引用格式：
[1]Guang-mei Wang;Yong Li;Shuo Wu;Wen Zheng;Jing-jing Ma;Feng Xu;Jia-qi Zheng;He Zhang;Jia-li Wang;Yu-guo Chen-.The combination of creatine kinase-myocardial band isoenzyme and point-of-care cardiac troponin/contemporary cardiac troponin for the early diagnosis of acute myocardial infarction)[J].世界急诊医学杂志（英文）,2022(03):163-168
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combination,creatine,kinase,myocardial,band,isoenzyme,point,care,cardiac,troponin,contemporary,early,diagnosis,acute,infarction,BACKGROUND,AMI,remains,challenging,especially,institutions,without,high,sensitive,hs,cTn,Herein,we,aim,assess,value,MB,combined,different,assays,METHODS,This,multicenter,observational,study,included,patients,chest,pain,from,September,We,classified,participants,into,three,groups,according,POC,diagnostic,was,quantified,using,sensitivity,area,under,curve,RESULTS,Compared,single,combining,increased,In,contrast,did,not,change,compared,alone,subgroup,analysis,symptom,onset,while,significantly,decrease,that,within,CONCLUSIONS,may,valuable,when,available
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0.371739
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